12/25/2019

NAME: DANIEL YILMA

ID.NO.: ATR/1213/10
SUBMITTED TO: MR EPHREM
CENTER OF BIOMEDICAL ENGINEERING
BIOFLUID Assignment on unit 3
How is valve disease diagnosed, treated?
by using
1. Echocardiogram (echo): - High frequency sound waves are sent through a transducer wand
that is placed on your chest. This produces pictures of the heart's valves, chambers and
pumping action of the heart. An echo can show a narrowed or insufficient valve.

2. Transesophageal echo (TEE): - During a TEE, a sound-wave transducer is placed on the end of
a special tube (called an endoscope) and passed into the mouth and down the esophagus (food
pipe). This lets your doctor get a closer look at the valves, the heart chambers and the back of
the heart.

3. Electrocardiogram (EKG or ECG): - A picture on graph paper of the electrical impulses

traveling through the heart muscle. Electrodes (small, sticky patches) are placed on the body,
and they send the information that creates the picture. an EKG can detect abnormal electrical
activity in the heart.

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4. Cardiac catheterization (cardiac cath or coronary angiogram): - An invasive imaging
procedure sued to check heart function. During a cardiac catheterization, a long, narrow tube
(catheter) is guided through a blood vessel in the arm or leg to the heart with the help of a
special X-ray machine. Contrast dye is injected through the catheter, and X-ray movies are
created as the dye moves through the heart. A cardiac cath can detect a narrowed or
insufficient valve, as well as looks at your coronary arteries and heart chambers.

5. Magnetic resonance imaging (MRI): - A large magnet and radio waves are used to produce a
picture of the heart's valves and chambers. It can create moving images of the heart as it is

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pumping and can detect abnormal blood flow through the heart.

Explain types of valve repair surgeries?

The aortic valve and the mitral valve are the most commonly replaced valves. Pulmonary and
tricuspid valve replacements are fairly uncommon in adults.
In replacing a narrow valve The most common valve surgical procedure is aortic valve
replacement for aortic stenosis, or narrowing of the aortic valve. Mitral stenosis is another
condition that sometimes requires a valve replacement procedure.

In replacing a leaky valve: Aortic regurgitation, (sometimes referred to as aortic insufficiency) is

another common valve problem that may require valve replacement. Regurgitation means that
the valve allows blood to return back through the valve and into the heart instead of moving it
forward and out to the body. Aortic regurgitation can eventually lead to heart failure.
Mitral regurgitation can be caused by a primary disease of the valve leaflets (so-called primary
MR, which is most commonly caused by "degenerative" or myxomatous mitral valve disease in
developed countries). It may also require a valve replacement. In this condition, the mitral valve
allows oxygenated blood to flow backwards into the lungs instead of continuing through the
heart as it should. People with this condition may experience shortness of breath, irregular
heartbeats and chest pain.

Surgical options for valve replacement include:

 Mechanical valve — a long-lasting valve made of durable materials

 Tissue valve (which may include human or animal donor tissue)
 Ross Procedure — “Borrowing” your healthy valve and moving it into the position of the
damaged valve aortic valve
 TAVI/TAVR procedure — Transcatheter aortic valve replacement
 Newer surgery options

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Types of valve repair surgeries

 Transcatheter aortic valve replacement (TAVR) : Transcatheter aortic valve replacement

is sometimes called transcatheter aortic valve implantation (TAVI). TAVR is a minimally
invasive procedure to treat aortic stenosis (narrowed aortic valve that fails to open
properly), not an open surgery. TAVR provides treatment for people who cannot have
an open surgery, as well as for people at moderate risk for surgery who prefer a
minimally invasive alternative. TAVR can relieve the signs and symptoms of aortic valve
stenosis and may improve survival in people who can't undergo surgery or have a high
risk of surgical complications.
 Bioprosthetic valve replacement: Surgical valve replacement is performed with
mechanical or bioprosthetic valves. For most patients, a choice is made between a
mechanical valve or a stented bioprosthesis. Current mechanical options include
bileaflet (e.g, St. Jude, Carbomedics, and On-X valves) and low thrombogenicity single
tilting disc valves (e.g, Medtronic Hall)
Bioprosthetic valve options include pericardial and xenograft (i.e, from a different
species; e.g, porcine, bovine, or equine) valves. Pericardial and xenograft valves may be
stented or stentless. Bioprosthetic aortic valve options also include aortic homografts
(i.e., a section of aorta with its aortic valve intact from a human donor) and the Ross
procedure (pulmonary autograft [the patient's own pulmonic valve] in the aortic
position to replace a diseased aortic valve; the pulmonic valve is replaced with a
pulmonary homograft). Stented bioprosthetic valves are the most common
bioprosthetic option.

 Transcatheter mitral valve repair (TMVR) : Transcatheter mitral valve repair (TMVR) is a
minimally invasive technique for treatment of selected patients with symptomatic
chronic moderate-severe or severe mitral regurgitation (MR).
Use catheters and a special device called the MitraClip to perform a repair. The
MitraClip is a transcatheter technology based on the surgical edge-to-edge repair,
which involves suturing together the middle segments of the anterior and posterior
mitral valve leaflets, thereby creating a "double orifice" mitral regurgitant area.
 Balloon valvuloplasty: A balloon valvuloplasty, also known as valvuloplasty or balloon
valvotomy, is a procedure to repair a heart valve that has a narrowed opening. In a
valvuloplasty, a doctor inserts a long, thin tube (catheter) with a balloon on the tip into
an artery in your arm or groin (the area between the abdomen and the thigh on either
side of the body) and guides it to the narrowed valve in the heart using X-ray imaging. A
doctor then inflates the balloon, which expands the opening of the valve and separates
the leaflets. The balloon is then deflated, and the catheter and balloon are removed.
By temporarily inflating a balloon in your valve, doctors can relieve narrowing
(stenosis). The procedure does not replace your valve and usually does not provide a
permanent fix for adults. it is recommended if:
o You cannot undergo a valve replacement right away

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 o Other procedures or surgeries do not provide good options

References
[1] https://my.clevelandclinic.org
[2] https://www.heart.org
[3] https://stanfordhealthcare.org
[4] https://www.mayoclinic.org
[5] https://www.uptodate.com
[6] https://i.stack.imgur.com [7] http://interventions.onlinejacc.org